Sustained Natural Apophysial Glide Versus Instrument Assisted Soft Tissue Mobilization in Patients With Chronic Mechanical Neck Pain

Overview

this study will be conducted to investigate the effect of sustained natural apophysial glide and Instrument assisted soft tissue mobilization on pain intensity, cervical range of motion and neck functional disability level in patients with chronic mechanical neck pain

Detailed description

Neck pain is a common musculoskeletal disorder in the era of technology. The International Association for the Study of Pain (IASP) has defined neck pain as:"Pain perceived as arising from anywhere with in the region bounded superiorly by superior nuchal line, inferior by an unoriginally transverse line through the tip of first thoracic spinous process, and laterally by saggital plane tangential to the lateral border of neck. Mulligan pioneered specific manual approach called mobilization with movement (MWM).The advance of this approach was aimed for application on the spinal joints. He claimed that his technique could improve the spinal range of motion (ROM) and decrease pain through the correction of a positional fault occurring between the surfaces of the involved facet joints. The most commonly used Mulligan technique is called "sustained natural apophyseal glides" or SNAGs, this technique has introduced in 1999 by Mulligan and is performed by applying an accessory glide along the axis of the facet joint of the affected level while the patient is doing an active movement from weight-bearing position. The pressure applied by the therapist in a cephalad direction over the spinous process (centrally) or the transverse process (unilaterally) or to the articular pillar of the affected vertebra.The IASTM therapy is designed to promote the restart of connective tissues by resorbing extra fibroses, encouraging collagen secondary to fibroblast recruited healing. In turn this leads to scar tissues, adhesions, and fascial limitations being released and broken down. M2t blade is a multifunctional instrument invented by Adam Bro ger that is reasonable in price and has many planes that can be used in treatment. Its efficiency in improving patients symptoms was proven through many studies. sixty patients with mechanical neck pain will be assigned randomly into three equal group; group A will receive mulligan plus traditional, group B will receive IASTM plus traditional and group C will receive traditional only

Interventions

• Other sustained natural apophysial glide
  The patients will be in the sitting position and asked to move their head in the direction that particularly produces their symptoms. As the participant moves their head, the physiotherapist gently glides the painful vertebra anteriorly and sustains the glide through the movement. During the application of the glide, the participant should stay symptom free and is instructed to stop moving if any PAIN is produced. This movement was repeated for 10 times for 3 sets, The interval between the sets
• Other instrument assisted soft tissue mobilization
  The subject will be in comfortable sitting position leaning on a treatment table with the arm crossed to rest the head. After cleaning the skin of the subject and the blade with alcohol swabs, a lubricant (Vaseline) was applied, and a sweeping technique was used to apply a deep yet comfortable soft tissue mobilization on the upper trapezius from origin to insertion for approximately 3 min. First, M2T blade will be utilized to locate the precise locations of limitation in the affected muscles. S
• Other conventional physical therapy
  the patients will receive conventional physical therapy in the form of Infrared, TENS , stretching exercices, isometric exercises

Primary outcome measures

• neck disability [Time frame: up to four weeks]

Secondary outcome measures (2)

• pain intensity [Time frame: up to four weeks]
• cervical range of motion [Time frame: up to four weeks]

Eligibility criteria

Inclusion criteria

• Sixety patients of chronic mechanical neck pain diagnosed and reffered from physicians will be participants in the study .
• Patients of both genders will be included.
• The age of the participants will beranged from 20 and 55 years
• The BMI ranged between 18.9 and 25 kg/m2
• All patients who suffered from neck pain more than 3 months.

Exclusion criteria

• Malignancy
• cervical and cranial surgery
• Recent fractures
• spinal tumors
• severe disc herniation
• uncontrolled hypertension
• Heart Disease ( arrhythmia, pacemaker).
• Pregnant and breast feeding women.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Center list to be confirmed — check the primary protocol.

Identifiers

NCT: NCT06720116 · P.T.REC/012/005464

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗